scholarly journals Cost Effectiveness Analysis of Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis. A Systematic Review Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Maurizio Benucci ◽  
Gianantonio Saviola ◽  
Mariangela Manfredi ◽  
Piercarlo Sarzi-Puttini ◽  
Fabiola Atzeni
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
Disease Activity ◽  
Disease Onset ◽  
Critical Evaluation ◽  
Joint Damage ◽  
Review Literature ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Disease Modifying

The cost effectiveness of treatments that have changed the “natural history” of a chronic progressive disease needs to be evaluated over the long term. Disease-modifying antirheumatic drugs (DMARDs) are the standard treatment of rheumatoid arthritis (RA) and should be started as early as possible. A number of studies have shown that they are effective in improving disease activity and function, and in joint damage. Our review was focused on revision and critical evaluation of the studies including the literature on cost effectiveness of DMARDs (cyclosporine A, sulphasalazine, leflunomide, and methotrexate). The European League Against Rheumatism (EULAR) recommendations showed that traditional DMARDs are cost effective at the time of disease onset. They are less expensive than biological DMARDs and can be useful in controlling disease activity in early RA.

scholarly journals Cost-effectiveness of Anbainuo Plus Methotrexate Compared to Conventional Disease-modifying Antirheumatic Drugs for Rheumatoid Arthritis Patients in China

2020 ◽  
Author(s):  
Feng Tian ◽  
Zhenhua Wen ◽  
Jingyang Li ◽  
Xiaowen Luo ◽  
Li Deng ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
Disease Activity ◽  
Sensitivity Analyses ◽  
Control Group ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Life Years ◽  
Disease Modifying ◽  
The Cost

Abstract Background: This study aimed to evaluate the cost-effectiveness of anbainuo (ABN) plus methotrexate (MTX) versus conventional disease-modifying antirheumatic drugs (cDMARDs) in Chinese rheumatoid arthritis (RA) patients. Methods: Ninety RA patients who underwent ABN+MTX (assigned as ABN+MTX group (N=47)) or cDMARDs (assigned as control group (N=43)) treatment were analyzed. Disease activity was assessed at baseline (M0), 3rd month (M3), 6th month (M6) and 12th month (M12) after treatment. Drug, other medical, indirect and total costs were calculated. Then pharmacoeconomic analyses were performed with the threshold of cost-effectiveness set as 3 times of the mean gross domestic product per capita in China during the study period.Results: Treatment response rate was similar, while disease remission and low disease activity rates were increased in ABN+MTX group compared to control group. Drug cost, other medical cost and total cost were higher in ABN+MTX group than control group, while indirect cost was similar between the two groups. Meanwhile, the quality-adjusted life years (QALY) in ABN+MTX group and control group were 0.72 and 0.48 years, respectively. The incremental cost-effectiveness ratios (ICER) of ABN+MTX group compared to control group in total patients, moderate-disease-activity patients and severe-disease-activity patients were ¥135486.7, ¥146450.4 and ¥124987.2/QALY, respectively, which were all below cost-effectiveness threshold. Further sensitivity analyses revealed that the cost-effectiveness of ABN+MTX versus cDMARDs was relative robust, while among all the indexes, ABN price and HAQ-DI score change for ABN+MTX group affected ICER most.Conclusions: ABN+MTX treatment presents acceptable cost-effectiveness compared to cDMARDs treatment in Chinese RA patients.

scholarly journals Comparison of clinical manifestations of rheumatoid arthritis in patients with moderate or high disease activity depending on the presence or absence of symptoms of neuropathic pain

2021 ◽  
Vol 15 (6) ◽  
pp. 13-18
Author(s):  
E. Yu. Polishchuk ◽  
E. S. Filatova ◽  
A. E. Karateev ◽  
V. N. Amirdzhanova ◽  
V. A. Nesterenko
Keyword(s):  
Rheumatoid Arthritis ◽  
Neuropathic Pain ◽  
Disease Activity ◽  
Pain Intensity ◽  
Clinical Manifestations ◽  
High Disease Activity ◽  
Control Group ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Disease Modifying

Objective: to study the effect of neuropathic pain symptoms (SNP) on the clinical manifestations of rheumatoid arthritis (RA) in patients with moderate or high disease activity.Patients and methods. The 1st (main) group included 58 RA patients (84.5% of women, age 53.0±11.9 years), in whom SNP were identified using the DN4 (≥4) and PainDETECT (≥13) questionnaires. The 2nd (control) group included 43 patients with RA (79.1% women, age 48.8±14.4 years) who did not have SNP (DN4 ≤4 and PainDETECT ≤13). All patients received disease-modifying antirheumatic drugs (mainly methotrexate and leflunomide), 20% – biologic disease-modifying antirheumatic drugs. We compared groups 1 and 2 for RA activity (DAS28, CDAI, SDAI), pain intensity on a visual analogue scale (VAS, 0–100 mm), functional impairment (HAQ), patient global assessment (PGA, VAS), number of painful and swollen joints, quality of life (EQ-5D), signs of anxiety and depression (HADS), CRP level.Results and discussion. The RA activity in patients of the 1st and 2nd groups did not differ statistically significantly. Patients of the 1st group showed significantly higher indicators of the severity of pain, PGA and anxiety than patients of the control group: 71.0±12.5 and 54.7±17.5 mm, respectively (p<0.001); 61.0±13.1 and 53.7±15.3 mm (p=0.045); 62.1 and 28.6% (HADS ≥7; p<0.001), respectively.Conclusion. SNP are associated with higher rates of pain intensity, PGA, and anxiety in RA patients with moderate to high disease activity.

scholarly journals Anti-Cyclic Citrullinated Peptide and Rheumatoid Factor (Prevalence and Association) in Saudi Rheumatoid Arthritis Patients

2018 ◽  
Vol 25 (2) ◽  
pp. 1-10
Author(s):  
Mohammad-Ayman A. Safi ◽  
Dhiya T. Houssien
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Rheumatoid Factor ◽  
Disease Duration ◽  
Direct Impact ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Disease Modifying Drugs ◽  
Disease Modifying ◽  
Citrullinated Peptide

To assess the prevalence and association of anti-cyclic citrullinated peptides and rheumatoid factor in Saudi rheumatoid arthritis patients.Over three years (February 2011 - February 2014). Demographic and clinical features, drugs, rheumatoid factor-positivity, and anti-cyclic citrullinated peptides-positivity were recorded for 205 Saudi rheumatoid arthritis patients (185 females; mean age was 45 years and mean disease duration was 5 years). Anti-cyclic citrullinated peptides and rheumatoid factor were assessed in serum. Disease activity scores for 28 joints was used. There were 36% rheumatoid factor+ve and 45% anti-cyclic citrullinated peptides+ve. 21.5% of the rheumatoid factor-ve subjects were anti-cyclic citrullinated peptides+ve. 13.3% of the rheumatoid factor positive patients were anti-cyclic citrullinated peptides-ve and 86.7% were anti-cyclic citrullinated peptides+ve. Significant association (P < 0.05) of anti-cyclic citrullinated peptides-positivity and rheumatoid factor-positivity with each other, and with gender, use of disease–modifying antirheumatic drugs, hydroxychloroquine and methotrexate. No direct impact of anti-cyclic citrullinated peptides status on the disease activity scores for 28 joints or its constituents (P > 0.5); nevertheless, anti-cyclic citrullinated peptides positive patients appear to represent a greater need for combination disease modifying drugs. 

scholarly journals Optimising Response to Advanced Therapies in Rheumatoid Arthritis – Using Prehabilitation to Improve Success?

2020 ◽  
pp. 87-95
Author(s):  
Alice Mason ◽  
Mariam Malik
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Tnf Inhibitors ◽  
Response To Therapy ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Ongoing Research ◽  
Advanced Therapies ◽  
Disease Modifying

In recent years, a new concept of prehabilitation, enhancing an individual’s functional capacity ahead of a medical intervention, has begun to be explored in the fields of surgery and oncology, with positive results. This article explores applying the principle of prehabilitation to patients with rheumatoid arthritis prior to starting advanced therapies, including biologic disease-modifying antirheumatic drugs and targeted synthetic disease-modifying antirheumatic drugs. In this article, the literature is reviewed and the existing evidence is summarised, and the suggestion is that this approach could improve a patient’s chance of achieving low disease activity or remission. There are a number of opportunities for improving the likelihood of patients with rheumatoid arthritis having a good response to therapy. Research shows that smokers starting TNF inhibitors are less likely to achieve a good response compared to non-smokers. Obese patients are also less likely to achieve a good response with TNF inhibitors; female patients with obesity may be less likely to achieve a good response with tocilizumab and early real-world data suggest there may be a reduced response to JAK inhibitors. Rheumatoid arthritis patients experiencing depression are less likely to respond to TNF inhibitors. Increased physical activity is potentially beneficial for all rheumatoid arthritis patients, although the effect on response to specific drugs has been less widely explored. Prehabilitation approaches could include targeting smoking cessation, improving physical activity, providing psychological support, optimising BMI, and dietary changes. A number of studies have shown that each of these interventions can lead to significant improvements in disease activity scores, with some patients potentially benefitting from more than one intervention. The authors identify principles for delivering prehabilitation in practice and suggest that this is an exciting area for ongoing research.

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